This invention relates to an operating instrument insertion apparatus for inserting an operating instrument to the affected part while incising the tissue.
JP-A-9-140659 discloses an endoscope comprising an operation body portion, an insertion portion connected to the operation body portion for insertion into a body cavity, an illumination window provided at a distal end portion of the insertion portion, an observation window provided at the distal end portion of the insertion portion, a treatment instrument insertion channel provided in the distal end portion of the insertion portion, a nozzle provided at the distal end portion of the insertion portion for feeding air and water, and an operating knob mounted on the operation body portion for directing the distal end portion of the endoscope in a desired direction. The distal end surface of the distal end portion of the endoscope, at which the illumination window, the observation window, the treatment instrument insertion channel and the nozzle are provided, need to be flat, and therefore the distal end portion of the endoscope has a substantially cylindrical outer shape. In this endoscope, consideration is given to the insertion of the insertion portion through the oral cavity and the pharynx into the esophagus and further into the stomach and further into the duodenum, and in order to enable the insertion portion to be easily passed through narrow portions of the insertion path, a cap, having a streamline-shaped distal end, is fitted on the distal end of the endoscope. This cap can be removed from the insertion portion by projecting a forceps or the like from the distal end of the treatment instrument insertion channel.
The above conventional endoscope is designed to be inserted into a cavity in the human body having the insertion spaces (though narrow) such as the oral cavity, the pharynx, the esophagus, the stomach and the duodenum. Therefore, any consideration is not given to the insertion of the operating instrument into the tissue for the purpose of treating the affected part in the tissue.
It is an object of this invention to provide an operating instrument insertion apparatus capable of easily inserting an operating instrument into the tissue.
According to the present invention, there is provided an operating instrument insertion apparatus comprising a hollow tubular member for receiving an operating instrument therein, and a plurality of scoop-like members provided at a distal end of the hollow tubular member;
wherein the plurality of scoop-like members can be opened in such a manner that distal ends of the scoop-like members are moved away from each other in a direction transverse to a direction of insertion of the scoop-like members into the tissue, and the plurality of scoop-like members can be closed in such a manner that the distal ends of the scoop-like members are moved toward each other in the transverse direction.
In this construction, the plurality of scoop-like members, when opened, can spread the tissue, and by repeating this operation and the incision, the distal end of the tubular member can be inserted into a position near to the affected part. When the plurality of scoop-like members are opened, a treatment space, enabling the operation of the operating instrument, is formed between the distal end of the tubular member and the distal ends of the scoop-like members, and therefore the operating instrument can be projected into this space from the distal end of the tubular member so as to effect the treatment.
In the open condition of the plurality of scoop-like members, the operating instrument for incision purposes may be projected from the distal end of the tubular member so as to effect the incision. Alternatively, incision means such as a cautery knife may be provided at the distal end of the scoop-like member, and the incision can be effected in the closed condition of the plurality of scoop-like members.